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Identifying phenotypic and physiological subgroups of preschoolers with autism spectrum disorder

Research output: Contribution to journalArticlepeer-review

Tessel Bazelmans, Emily J. H. Jones, Sheila Ghods, Sarah Corrigan, Karen Toth, Tony Charman, Sara J. Webb

Original languageEnglish
JournalPsychological Medicine

Bibliographical note

Funding Information: Funding for this study was provided by Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01 HD064820, Webb). TB's was supported by a grant from the European Commission's Horizon 2020 Program under grant agreement no. 642990 (Brainview) and the Medical Research Council (G0701484 and MR/K021389/1). EJHJ and TC were supported by EU-AIMS (the Innovative Medicines Initiative joint undertaking grant agreement no. 115300, resources of which are composed of financial contributions from the European Union's Seventh Framework Programme (grant number FP7/2007-2013) and EFPIA companies' in-kind contribution) and AIMS-2-TRIALS (the Innovative Medicines Initiative 2 Joint Undertaking under grant agreement no. 777394, resources of which are composed of financial contributions from the European Union's Horizon 2020 research and innovation programme and EFPIA and Autism Speaks, Autistica and SFARI.) Publisher Copyright: Copyright © The Author(s), 2021. Published by Cambridge University Press. Copyright: Copyright 2021 Elsevier B.V., All rights reserved.

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Background To understand the emergence of symptoms in autism spectrum disorder (ASD), we need to identify the mechanisms that underpin the development of core social skills. Mounting evidence indicates that young children with later ASD attend less to other people, which could compromise learning opportunities with cascading effects. Passive looking behaviour does not tell us about engagement with visual information, but measures of physiological arousal can provide information on the depth of engagement. In the current study, we use heart rate (HR) and heart rate variability (HRV) to measure engagement with social dynamic stimuli in ASD. Methods Sixty-seven preschoolers with ASD and 65 typical developing preschoolers between 2 and 4 years of age participated in a study where HR was measured during viewing of social and non-social videos. Using latent profile analyses, more homogeneous subgroups of children were created based on phenotype and physiology. Results Preschool-aged children with ASD, regardless of their non-verbal, verbal and social competencies, do not differ in overall HR or HRV compared to TD children. However, the ASD group showed a larger increase in HR (more disengagement) than the TD group to later-presented social stimuli. Phenotypic and physiological profiles showed this was primarily the case for children with below average verbal and non-verbal skills, but not necessarily those with more ASD symptoms. Conclusion Children with ASD, especially a subgroup showing moderate cognitive delays, show an increase in HR to social stimuli over time; this may reflect difficulties re-engaging with social information when attention is waning.

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